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Prospective evaluation of the bisap score in assessing mortality and intermediate markers of severity in acute pancreatitis’

Author:

Burhan T. Kaydawala and Nimish J. Shah

Subject Area:

Social Sciences and Humanities

Abstract:

Background: There is a need for a simple and clinically oriented severity scoring system that can predict mortality of acute pancreatitis within 24 h of presentation. Early recognition of severe disease would enable the clinician to consider more aggressive interventions within a time frame that could potentially prevent adverse outcomes. (1) The Bedside Index for Severity in Acute Pancreatitis (BISAP) is a new, convenient, prognostic multifactorial scoring system.(8) In this study of patients with acute pancreatitis, we evaluate the BISAP SCORE in assessing mortality and intermediate markers of severity in an acute pancreatitis. Aim and Objectives: 1. To evaluate the accuracy of the BISAP SCORE to predict mortality in acute pancreatitis patients from our institution. 2. To assess the accuracy of the BISAP SCORE to predict which patients are at risk for intermediate markers of severity including the development of organ failure, persistent organ failure and pancreatic necrosis. Methods: This prospective observational study was conducted in the SSG hospital between APRIL 2015 to JANUARY 2016. Total 70 patients were diagnosed to have acute pancreatitis at SSGH from APRIL 2015 to JANUARY 2016. BISAP scores were calculated on all patients based on data obtained within 24 h of presentation. Results: In our study out of 70 patients, 9 patients (12.85%) expired. The sensitivity of BISAP score in predicting the mortality in acute pancreatitis was 88.9% ,for the same specificity was 83%. This results were statistically significant with p value for BISAP score being 0.001. There was a statistically significant trend for increasing mortality with increasing BISAP score. The sensitivity of BISAP score in predicting the development of organ failure was 75%, for the same specificity was 84%. This results were statistically significant with p value for BISAP score being 0.001. The sensitivity of BISAP score in predicting the development of necrosis was 55.6%, for the same specificity was 82%.This results were statistically significant with p value for BISAP score being 0.03. Conclusion: The BISAP score stratifies patients within the first 24 h of admission according to their risk of in hospital mortality and is able to identify patients at increased risk of mortality prior to the onset of organ failure. The BISAP score represents a simple way to identify patients at risk of increased mortality and the development of intermediate markers of severity within 24 h of presentation.